Outline

Objective: The visual analogue scale (VAS) is an accepted tool in neurosurgical pain management of patients. The standardised scale is paper based. A face of a smiley is the indicator for the current pain level of a patient.

We developed a digital pain management system the e-VAS (electronic Visual Analogue Scale). The system allows iPod-touch/Smartphone based online pain-level data collecting and shows an integrated analysing tool for an optimized pain management of patient.

Methods: The pain diary application is running on a hand-held device featuring touch screen and gesture recognition. There are two modes to use system - the expert mode where the neurosurgeon or a nurse is collecting the data directly from the patient on his device. During the patient mode the device is in the hands of the patient and reminds him to judge his/her pain status according to the Visual Analogue Scale (VAS) up to several times a day at predefined intervals. At those given times, the patient inputs his medication intake according to the predefined list or with a free text editor. Other events (like meals or bowel movements) may be manually logged as well.To transfer the data back to the neurosurgeon, the handheld device uploads accumulated data as XML-files by cable connection, or by a secure WLAN connection to a dedicated desktop PC, thus enabling the neurosurgeon to analyze the patient log.

Results: In a first feasibility test the system showed a high acceptance by neurosurgeons, nurses but also by the patient themselves.

Even older patients used the system without further problems.

The implemented analysing tools of the application offer experts a better understanding of patient medication or surgical interventions correlated to the pain history. Treatment decisions can be made under an aspect of objectivity.

Conclusions: The e-VAS is running on a Smartphone/iPod-Touch and simplifies the management of pain patients. The integrated data analysing tools allows a quick overview about the patientÂ´s pain history. This is offering the background for important treatment decisions. The next step will be the integration of an HL7 interface for a direct communication to any medical information system and the ability of telemonitoring pain patients outside the hospital.